| (D) a medical equipment room which includes provisions
for the storage, repair, and testing of electronic and other medical
equipment;
(E) a separate room or building for yard maintenance
equipment and supplies. When a separate room is within the physical
plant the room shall be located so that equipment may be moved directly
to the exterior. Yard equipment or vehicles using flammable liquid
fuels shall not be stored or housed within the facility building;
and
(F) sufficient space in all mechanical and electrical
equipment rooms for proper maintenance of equipment. Provisions shall
also be made for removal and replacement of equipment.
(2) Additional areas or room(s). Additional areas or
room(s) for mechanical, and electrical equipment shall be provided
within the physical plant or installed in separate buildings or weatherproof
enclosures with the following exceptions.
(A) An area shall be provided for cooling towers and
heat rejection equipment when such equipment is used.
(B) An area for the medical gas park and equipment
shall be provided. For smaller medical gas systems, the equipment
may be housed in a room within the physical plant in accordance with
National Fire Protection Association 99, Standard for Health Care
Facilities, 1999 edition (NFPA 99), Chapters 4 and 8.
(C) When provided, compactors, dumpsters, and incinerators
shall be located in an area remote from public entrances.
(h) General stores.
(1) General. In addition to storage rooms in individual
departments, a central storage room shall also be provided. General
stores may be located in a separate building on-site with provisions
for protection against inclement weather during transfer of supplies.
(2) Receiving. Central storage areas shall be provided
with an off-street unloading and receiving area protected from inclement
weather.
(3) General storage room. General storage room with
a total area of not less than 12 square feet per inpatient bed shall
be provided. The storage room may be within the facility, or separate
building on-site. A portion of the storage may be provided off-site.
(4) Outpatient suite storage room. A storage room for
the outpatient services shall be provided at least equal to 5.0% of
the total area of the outpatient suite. This required storage room
area may be combined with general stores.
(i) Geriatric, Alzheimer, and other dementia nursing
suites. When geriatric, Alzheimer, or other dementia nursing suites
are provided, the nursing suite shall comply with the requirements
in subsection (o) of this section with the following exceptions.
(1) A patient bedroom suite shall be 120 square feet
in a single patient bedroom suite and 200 square feet in multiple-bed
room suites.
(2) Each patient bedroom shall have storage for extra
blankets, pillows, and linen.
(3) Patient bedroom doors shall be a minimum of three
feet eight inches in width.
(4) Patients shall have access to at least one bathtub
in each nursing suite.
(5) A minimum of two separate social spaces, one appropriate
for noisy activities and the other for quiet activities, shall be
provided. The combined total area shall be not less than 30 square
feet per bed space with not less than 140 square feet for each of
the two spaces, whichever is greater. This space may be shared with
the dining area or room.
(6) Storage space for wheelchairs shall be provided
in the nursing unit.
(j) Imaging suite.
(1) Architectural requirements.
(A) General. When diagnostic imaging services are provided,
the minimum the facility shall provide is a diagnostic radiographic
(X-ray) room.
(i) Diagnostic radiographic (x-ray) room size(s) shall
be in compliance with manufacturer's recommendation. When portable
x-ray equipment is used, the portable unit shall be stored in a secured
room.
(ii) When radiation protection is required for any
diagnostic imaging room, a medical physicist licensed under the Texas
Medical Physics Practice Act, Occupations Code, Chapter 602, shall
specify the type, location, and amount of radiation protection to
be installed for the layout and equipment selections.
(iii) Each X-ray room shall include a shielded control
alcove. The control alcove shall be provided with a view window designed
to permit full view of the examination table and the patient at all
times.
(iv) Warning signs capable of indicating that the equipment
is in use shall be provided.
(B) Service areas. The following service areas shall
be provided.
(i) Patient waiting area. The area shall be out of
traffic and under direct staff visual control.
(ii) Patient toilet rooms. Toilet room(s) with hand
washing amenities shall be located convenient to the waiting area.
(iii) Patient dressing rooms. Dressing rooms shall
be convenient to the waiting areas and X-ray rooms.
(iv) Hand washing facilities. A freestanding hand washing
fixture with hands-free controls shall be provided in or near the
entrance to each diagnostic and procedure room unless noted otherwise.
Hand washing facilities shall be arranged to minimize any incidental
splatter on nearby personnel or equipment.
(v) Contrast media preparation. This room shall include
a work counter, a sink with hands-free operable controls, and storage.
One preparation room may serve any number of rooms. When prepared
media is used, this area may be omitted, but storage shall be provided
for the media.
(vi) Film processing room. A darkroom shall be provided
for processing film unless the processing equipment normally used
does not require a darkroom for loading and transfer. When daylight
processing is used, the darkroom may be minimal for emergency and
special uses. Film processing shall be located convenient to the procedure
rooms and to the quality control area.
(vii) Quality control area or room. An area or room
for film viewing shall be located near the film processor. All view
boxes shall be illuminated to provide light of the same color value
and intensity.
(viii) Film storage (active). A room shall include
a cabinet or shelves for filing patient film for immediate retrieval.
(ix) Film storage (inactive). A room for inactive film
storage shall be provided. It may be outside the imaging suite, but
must be under the administrative control of imaging suite personnel
and be properly secured to protect films against loss or damage.
(x) Storage for unexposed film. Storage amenities for
unexposed film shall include protection of film against exposure or
damage.
(xi) Storage of cellulose nitrate film. When used,
cellulose nitrate film shall be stored in accordance with the requirements
of National Fire Protection Association 40, Standard for the Storage
and Handling of Cellulose Nitrate Motion Picture Film, 1994 edition.
(xii) Housekeeping room. The room may serve multiple
departments when conveniently located.
(2) Details and finishes. Details and finishes shall
be in accordance with §134.122(d)(2) of this title and this paragraph.
(A) Details.
(i) Radiation protection shall be designed, tested
and approved by a medical physicist licensed under the Texas Medical
Physics Practice Act, Occupations Code, Chapter 602.
(ii) The design and environmental controls associated
with licensable quantities of radioactive material in laboratories
and/or imaging rooms shall be approved by the Texas Department of
Health's Bureau of Radiation Control prior to licensed authorizations.
(iii) Where protected alcoves with view windows are
required, provide a minimum of 1 foot 6 inches between the view window
edge/frame and the outside partition edge.
(iv) Imaging procedure rooms shall have ceiling heights
not less than nine feet. Ceilings containing ceiling-mounted equipment
shall be of sufficient height to accommodate the equipment of fixtures
and their normal movement.
(B) Finishes.
(i) Flooring used in contrast media preparation and
soiled workroom shall be of the seamless type as required by §134.122(d)(2)(B)(iii)(III).
(ii) A lay-in type ceiling is acceptable for the diagnostic
room.
(3) Mechanical Requirements.
(A) Mechanical requirements shall be in accordance
with §134.122(d)(3) of this title and this paragraph.
Cont'd... |
